PROJECT SUMMARY This project aims to generate a body of data that will assist in formulating appropriate policies for the reduction of morbidity and mortality associated with influenza and other respiratory pathogens. Specifically we aim to describe the burden, clinical spectrum, pathogenesis, transmission and outcomes of influenza and other respiratory pathogens in different age and risk groups in South Africa. We will assess the effectiveness and/or efficacy and safety of influenza vaccines in preventing laboratory-confirmed influenza in different risk groups of importance in low- and middle-income settings (for example pregnant women) as well as exploring alternate vaccination strategies such as targeting community transmitters. In order to achieve these objectives, we will use a combination of approaches including enhanced surveillance for pneumonia and influenza-like illness, community transmission studies, case-control studies, cohort studies, healthcare utilization surveys, vaccination demonstration projects and modelling. We will establish partnerships with relevant stakeholders locally and regionally to support research and surveillance activities, development of influenza vaccine production capacity and the translation of data into policy. Additional activities include conducting intensive community transmission studies to understand the community burden and transmission of influenza and interaction of influenza with other respiratory pathogens. We will use costing data obtained from surveillance combined with modelling approaches to evaluate cost-effectiveness of different influenza vaccination approaches. We will strengthen capacity to identify and respond to novel influenza viruses at the animal-human interface and work to build laboratory and epidemiology capacity for influenza surveillance in the country and the region.